Comprehensiveness and programmatic vulnerability to stds/hiv/aids in primary care / La integralidad y vulnerabilidad programática de las ets/vih/sida en la atención básica / A integralidade e a vulnerabilidade programática às DST/HIV/AIDS na Atenção Básica




This study aimed to identify programmatic vulnerability to STDs/HIV/AIDS in primary health centers (PHCs). This is a descrip - tive and quantitative study carried out in the city of São Paulo. An online survey was applied (FormSUS platform), involving administrators from 442 PHCs in the city, with responses received from 328 of them (74.2%), of which 53.6% were nurses. At - tention was raised in relation to program - matic vulnerability in the PHCs regarding certain items of infrastructure, prevention, treatment, prenatal care and integration among services on STDs/HIV/AIDS care. It was concluded that in order to reach comprehensiveness of actions for HIV/ AIDS in primary health care, it is necessary to consider programmatic vulnerability, in addition to more investment and reor - ganization of services in a dialogue with the stakeholders (users, multidisciplinary teams, and managers, among others).


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Objetivo Fue identificar la vulnerabilidad programática de las Unidades Básicas de Salud con la atención a las ETS/VIH/SIDA. Método Es un estudio descriptivo con un abordaje cuantitativo llevado a cabo en el Municipio de San Pablo. Fue utilizado un formulario online (el FormSUS) con los gerentes de las 442 Unidades Básicas de Salud del Municipio de San Pablo. Participaran en el estudio 74.2% de los gerentes, estos 53.6% eran enfermeros. Resultados Se destaca la vulnerabilidad programática de las Unidades Básicas de Salud en relación a algunos elementos de la infraestructura, acciones de prevención, tratamiento, prenatal y la integración entre los servicios en la atención a las ETS/VIH/SIDA. Conclusión La construcción de tales marcadores constituye un instrumento, presentado en otro artículo, el cual puede ayudar a apoyar la captura de vulnerabilidades de las mujeres en relación a las ETS/VIH en el contexto de los servicios de Atención Primaria de Salud. Los marcadores constituyen importante herramienta para operacionalizar el concepto de vulnerabilidad en la Atención Primaria. Además, promueven procesos de trabajo inter e multidisciplinar e inter e multisectorial. La propuesta de un instrumento basado en dichos marcadores puede apoyar la captura de la vulnerabilidad de las mujeres en relación a las ETS/VIH. .

Objetivo Identificar a vulnerabilidade programática às DST/HIV/aids na Atenção Básica para o enfrentamento do HIV/Aids. Método Estudo descritivo, com abordagem quantitativa, realizado no Município de São Paulo (MSP). Utilizou-se formulário online (FormSUS), com gerentes das 442 Unidades Básicas de Saúde (UBS) do MSP. Participaram do estudo 74,2% gerentes, dos quais 53,6% eram enfermeiros. Resultados Destaca-se a vulnerabilidade programática nas UBS com relação a alguns itens de infraestrutura, ações de prevenção, de tratamento, no pré-natal e de integração entre os serviços na atenção às DST/HIV/aids. Conclusão Para a efetivação da integralidade no enfrentamento do HIV/aids na Atenção Básica é necessário atentar para a vulnerabilidade programática, além de mais investimentos e reorganização dos serviços, num diálogo com os atores sociais envolvidos (usuários, equipe multiprofissional, gerentes, gestores, entre outros).


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Impacto dos genes IgVH, LPL, ADAM29 e da proteína Zap-70 no prognóstico da leucemia linfocítica crônica / Prognostic impact of IgVH, LPL and ADAM29 genes, and Zap-70 protein in chronic lymphocytic leukemia

Objetivo: A leucemia linfocítica crônica (LLC) é marcada pela heterogeneidade evolutiva, que não pode ser prevista pelos atuais sistemas de estadiamento clínico. Recentemente, o estado mutacional dos genes IgVH vem sendo considerado como o melhor marcador de prognóstico nesta doença. No entanto, sua análise não é aplicável à rotina clínica, sendo o nosso principal objetivo o encontro de um marcador substituto (surrogate) de fácil utilização e reprodutibilidade. Métodos: Foram estudados pacientes com LLC acompanhados pelo Grupo Cooperativo Francês em LLC, pela Universidade Federal de São Paulo ou pelo Hospital do Servidor Público Estadual-SP. Inicialmente, investigamos a possibilidade de substituição do estudo IgVH pelo estadiamento clínico de Binet. A seguir, empregamos a técnica de microarrays buscando marcadores surrogate no perfil de expressão gênica diferencial entre os grupos IgVH mutado e não-mutado. Enfim, utilizamos RT-PCR quantitativa e citometria de fluxo para validação de nossos achados numa série ampliada de pacientes, onde analisamos o impacto da expressão de cada marcador em relação ao prognóstico na LLC. Resultados: O estadiamento clínico de Binet e o estado mutacional IgVH mostraram-se como fatores independentes, porém complementares, de prognóstico na LLC. Encontramos os genes LPL, ADAM29 e ZAP-70 como potenciais surrogates ao estado mutacional IgVH. Confirmamos os resultados obtidos nos microarrays, e verificamos que os perfis de expressão da relação LPLIADAM29 e a da proteína Zap-70 possuem alta correlação com o estado mutacional IgVH e com o prognóstico na LLC. Além disso, a associação dos resultados de LPLIADAM29 e Zap-70 mostrou ser capaz de dispensar o estudo IgVH em 80 por cento dos pacientes. Conclusões: O estadiamento clínico ainda possui um papel independente de prognóstico na LLC, e a avaliação do estado mutacional IgVH pode ser substituída, num futuro próximo, por LPL, ADAM29 e Zap-70

Polimorfismo del ADN mitocondrial en una población indígena del noroeste argentino / Genetic plymorphism of mitochondrial DNA in a closed native population geographically located in northern Argentina

This study was undertaken to evaluate the genetic polymorphism of mitochondrial DNA in a closed native population geographically located in Northern Argentina

Variable kappa gene usage in swine antibodies

The kappa light chain locus of swine has been mapped to chromosome 3q12-q14 but at this time, there is not enough information comprising the variable region genes or their transcripts. Here we report the sequences of five transcripts of swine kappa light chain variable region obtained from the spleen of two adult Yorkshire pigs. The lengths of the deduced sequences of these transcripts were variable (between 107 to 112 amino acids). Comparisons of the nucleotide sequences of their variable regions with other species like human and murine VL genes shows a high degree of identity, indicating the use of at least two different families of variable light genes. The contribution of these genes to the generation of variability in swine light chain variable genes as well as their therapeutic use in humans is discussed. An interesting possibility would be the development of an antiretroviral vaccine, useful to protect against a potential risk of infections due to xenotransplantation (au)

Genetic relationships among serogroup B: serotype 4 Neisseria meningitidis strains

We compared the results obtained by serotyping of PorB epitopes using an expanded panel of monoclonal antibodies (mAb) including mAb 7 and mAb 10, with results obtained by RFLP of rRNA genes (ribotyping). The purpose of this study was to assess the correlation between phenotypic- and genotypic- methods for typing N. meningitidis. The ribotypes obtained using ClaI or EcoRV endonucleases grouped the strains in seven and two different patterns, respectively. This additional characterization of PorB epitopes improved the correlation between these two methods of typing N. meningitidis

Sequence analysis of the V1-V2 hypervariable region of the HIV-1 envelope gene from pediatric patients

The presence of HIV-1 DNA sequence variants of pediatric AIDS patients was investigated in a two-stage polymerase chain reaction (PCR) using nested primers for the first and second (V1-V2) hypervariable regions of the proviral envelope (gp 120) gene (env1). Gel electrophoresis analysis yielded amplified DNA bands which exhibited length variations which were characteristic for each child. The PCR products were cloned and the resulting clones demonstrated inserts of different lengths in a patient and between patients. Analysis of five clones from two different patients at the level of DNA sequencing indicates an extreme heterogeneity in the V1-V2 region. DNA maximum similarity between all of the isolated clones ranged between 69 to 96 percent. Comparison between DNA sequences of the isolated clones and HIV-1 strains of other parts of the world was also performed. The highest percentage of similarity that was found with known HIV variants included the following strains: HIVADA, HIVJFL, HIVSW42, HIVSWB83, HIVTRA2, HIVWMJ22. The sequences also showed a high degree of similarity to the clade B virus HIVSF162. The analyzed HIV-1 sequences demonstrated the expected high degree of variation in the V1-V2 region of the envelope gene and in some cases that the variation between isolates from the same patient may exceed the variation between the individual clones and the reference HIV-1 strains

Analysis of antibody specificity against the third variable region of the envelope glycoprotein gp120 of HIV-1 in plasma from HIV-1-positive individuals residing in Brazil

1. Antibody specificity for the principal neutralization domain (PND) of the human immunodeficiency virus type 1 (HIV-1) was studied in plasma from 122 HIV-1-infected individuals residing in Brazil. 2. Using 8 overlapping sequential pentadecapeptides corresponding to the third variable region (V3) of 5 different HIV-1 isolates in an enzyme-linked immunosorbent assay (ELISA), a preferential recognition of the peptides with amino acid sequences corresponding to the HIV-1 isolates IIIB and MN (maximal reactivities of 60-70) compared to the isolates SC, WMJ-2 or RF (maximal reactivities below 60) was observed. 3. A difference was observed in the overall reactivity pattern to HIV-1 SC peptides of plasma collected from individuals residing in the Brazilian states of Rio de Janeiro and Bahia. However, a statistically significant increased recognition by Bahian plasma was only observed for the HIV-1 SC C55 peptide. 4. The mean CD4/CD8 ratio of the group of plasma with an isolate-restricted recognition of peptides (0.522 +/- 0.074) was significantly lower than that of the total group of plasma (1.00 +/- 0.18).

Wa idiotype in seropositive rheumatoid arthritis

Antibodies against cross-reactive idiotypes (CRIs) may prove useful as phenotypic tracers of immunoglobulin variable region genes (VH or VL). CRIs of human rheumatoid factors (RFs) seem to be useful in the elucidation of the incidence and structural characteristics of the latter. Anti-Wa CRI antibodies were produced and an enzyme immunoassay was developed to test polyclonal RFs isolated from sera of 20 rheumatoid arthritis (RA) patients, 7 males and 13 females, aged 17 to 74 years. Seventeen patients had clinically active disease and three were in remission. Disease duration ranged from 1 to 25 years and RF titers ranged from 1:160 to 1:640. The immunoassay could detect as little as 8 ng of a monoclonal purified WaRF and positive results were found in 30 per cent of patient sera. Therefore, we may conclude that at least part of the RFs seen in RA patients derives from germ line genes